The objective of this proposal is to support the operation of the NIH NHLBI prevention and early treatment of acute lung injury (PETAL) Network> The Network's goal is to efficiently test drugs, devices, and protocols to prevent and treat early acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) thereby improving the short and long-term outcomes of patients. To achieve this goal the investigators will: 1. Provide organizational leadership to a Steering Committee and Subcommittees to establish an orderly, rational, process to develop, select, and conduct at least two clinical trials and to refine the Network's structure, and operating procedures. 2. Collaborate in the generation of hypotheses, development of protocols, and refinement of recruitment and data collection techniques and methods to acquire and analyze clinical data and samples. This effort will include collection of high quality biological and genetic specimens to allow Network members and others outside the network to study the genomics, proteomics and microbiome of acute lung injury. 3. Over 5.5 years recruit a minimum of 220, gender and ethnically representative subjects to clinical trials to generate quality data to test hypotheses posed by the Steering Committee. 4. Disseminate study results through high profile scientific publications and presentations.